Provider Demographics
NPI:1396297859
Name:ACUPUNCTURE CARE PC
Entity type:Organization
Organization Name:ACUPUNCTURE CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:212-927-8039
Mailing Address - Street 1:613 W 169TH ST
Mailing Address - Street 2:3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2914
Mailing Address - Country:US
Mailing Address - Phone:212-927-8039
Mailing Address - Fax:
Practice Address - Street 1:613 W 169TH ST
Practice Address - Street 2:3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2914
Practice Address - Country:US
Practice Address - Phone:212-927-8039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5347171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty